Is this a W-2 or 1099 position?

CASE physicians are employees of a medical corporation (CASE) and therefore, this is a W-2 position, rather than an independent contractor position with a 1099.  CASE was structured this way so that each physician does not have to pay minimum California corporate tax (saves $800 per year, per physician) and much less likely to be scrutinized by the IRS than a group of independent contractors would be.  CASE has a generous expense policy and legitimate tax deductions can be run through a Physician’s Compensation Report (PCR), prior to the W-2 payments.  A PCR is a physician’s business expense report ​where business expenses can be paid for with pre-tax dollars.

What benefits package is offered?

CASE works with several insurance brokers and strives to offer Anesthesiologists competitive premium rates for the various health insurance plans. Usually, the offerings include:  a high deductible (HSA- qualifying) PPO, a traditional PPO, and HMO options (such as Kaiser).  Dental and Vision insurance policies are also available.  Approximately 90% of the premium cost is paid pre-tax. CASE enrolls each physician in the group's term-life and long term disability (own occupation) policies.  If you want additional individual disability or life policies, you should consider purchasing one prior to starting with CASE.

Is there a retirement plan?

YES. CASE offers a Profit Sharing Plan, which is an IRS-approved 401(k)-style retirement plan that allows CASE physicians a great deal of flexibility with regards to how much money can be contributed in any given year. In addition, we also offer a Roth 401(k) option. CASE supports the maximum annual contributions as allowed by the IRS – for 2024 the combined contribution limit for most physicians is $70,000; those 50 years of age and older can contribute up to $77,500. Retirement funds may be invested in the core plan options (including a suite of target date funds) and/or placed in a Self-Directed Brokerage Account (which is directed by the participant).

I've heard about private practice groups selling to corporations---do you foresee this for CASE?

Private practice groups have sold to hospitals, practice management companies, and private equity groups, to name a few.  Over the last few years, we have received interest from some of these parties.  However, currently the CASE board does not believe that it makes sense for a well-run Physician-owned group to be under the control of another entity.  We value our group structure, lifestyle, and most importantly our independence.  We are the largest private group in Northern CA and have a reputation for providing top quality care to our patients for decades.  We do not plan on this changing in the foreseeable future.

Do most people make partner (or become a shareholder)?

Yes, almost everybody does.  We value teamwork, clinical excellence, and a professional attitude toward colleagues, patients, and staff:  demonstrate these qualities and you will make partner.  It is NOT our goal to bring new Anesthesiologists into the group, work them for a year or two, and then show them the door.  You are eligible to become a shareholder at the two-year anniversary of joining CASE.  We only want to hire physicians whom we expect to be long-term CASE physicians for the rest of their career in Anesthesiology.

What is your group Malpractice coverage like? 

Our current malpractice carrier is MIEC.  Our premium rates are set based on our Loss Experience and due to our skilled Anesthesiologists and our practice experience, our individual premium for a 1M/3M Claims Made policy is $3,717 a year per Physician - one of the lowest rates in the US.  There is also a stepped price policy for new hires, ie, reduced for the first 3 years. Currently, the first-year annual premium will be approximately $915.  

How much do people make?

Probably the most common question asked.  Since our group is productivity based, the answer is "depends on how much you want to work.”  Anesthesiologists do extremely well financially (most earn >450K per year).  We have income coming from two directions: stipends and insurance billing. All subgroups receive stipends for taking call and special services provided (like board runner or APS), but still most of our income is derived from units billed/produced.  It depends on how much vacation you like to take too. But with 6 to 10 weeks vacation/yr most of us are earning from $650k-$850k/yr.

Do CASE members qualify for Public Service Loan Forgiveness (PSLF)?

YES, because our hospitals are non-profit (Sutter and Dignity) you qualify for loan forgiveness: Since you are working for a non-profit hospital, after 10 years of paying your minimum loan payment each month, while working for a public or non-profit hospital, the outstanding balance of your loans are forgiven.

Is there a signing bonus or paid relocation expenses?

We are currently offering a $75,000 starting incentive! This is structured as a forgivable loan, contingent on remaining employed with us for a minimum of two years. It aims to assist with relocation expenses and to stay competitive in attracting top candidates nationwide. Additionally, numerous new practice expenses, such as a cell phone or computer, can be deducted from the physician’s PCR (pre-tax) earnings.

Am I expected to do Cardiac cases?

No. Physicians interested in specialized cardiac or pediatric anesthesia typically complete fellowship training and apply directly to those specific subgroups within CASE. However, if you’re comfortable managing routine pediatric cases, there are opportunities to care for healthy children at our outpatient surgery centers.

Are there opportunities to advance into a clinical leadership role (if desired)?

There are many opportunities to become involved in non-clinical activities and leadership positions if interested.  These include both activities at the hospital and CASE group administrative roles.  New physicians are encouraged to attend CASE group meetings to learn how the group functions and to see if there is a committee that they would like to become involved with.  CASE attempts to include all physicians, including new hires who are not yet shareholders: For example, non-Shareholders are encouraged to attend the annual CASE shareholders meeting.

How many anesthesiologists practice within the group?

Currently CASE has 110 anesthesiologists.  They are divided into Subgroups: Sacramento (65), Roseville (29), Auburn (7), and Woodland (9).  Among the Sacramento subgroup are three specialty subgroups including Cardiac, Obstetric, and Pediatrics.

What is the call schedule?  Does the schedule allow for a day off post-call?

Each CASE subgroup organizes their own call schedules.  In general, the frequency of call is lower than national averages.   Since physician compensation is primarily based on production, the more call you take the more you earn.  Most physicians like the day off after call, but the option to work post-call is often available if you want it.  We highly value our work-life balance and flexible scheduling, so that is left up to you to fit with your own priorities.

How much vacation time will I get?

All subgroups treat physicians equally, ie, senior physicians do not get priority.  The amount of vacation chosen by individuals each year varies from 2 weeks per year to 16 weeks per year. CASE prides itself in being flexible, and with production-based compensation this allows individuals to find the right work-life balance that fits their goals. So .. the real answer is: you can take as much vacation as you want.

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